Life’s Little Changes – THE FAT VS. MUSCLE FACTOR

Life’s Little Changes – The Fat vs Muscle Factor

BLOGGER:  JULIE WEBSTER

It is a known fact that as we age our bodies change.  Starting around the age of 45 we start to lose muscle mass at a rate of approximately 1% per year.  Although this doesn’t sound like a big deal, it really is.  The reason being is because at the same time our bodies are starting to lose muscle mass, most people are starting to gain weight.  The average American gains 1-2 pounds of weight per year as they age.  Again that doesn’t sound like a lot but if you average that over 10 years, you have gained 15 pounds!

Let’s look at that.  Muscle is about 18% denser than fat.  In other words, think about weight verses volume.  A pound is a pound but the amount of space one takes up verses the other is the key factor.  For an extreme example think about the weight of one pound of feathers verses one pound of brick.  Since the brick is so much denser, it would take up much less space than one pound of feathers would.  You get the point?

So, if muscle is 18% denser than fat and we are losing mass yet gaining weight what do you think we really gaining?  Fat, of course.  Our bodies are either staying the same size or, in many cases getting physically bigger.  Consequently our ratio of muscle to fat is changing dramatically.

Less muscle means less strength thus decreasing our ability to do even the little things.  I met a woman who could no longer carry her own groceries into the house because they had become too heavy and she was not very old!  Verses the woman who still lifts weights at 68 years old, looks fabulous and carries just about anything and everything she wants.  Big difference.  This doesn’t even address the bigger picture of doing the fun things.  I have a 77 year old friend that plays tennis like no body’s business.  She competed in a league a few weeks ago, played for 3 hours to win the overall competition, and she was playing against women in their 50’s.  Now that’s living!

A decrease in muscle mass does not only equate to less strength.  With less muscle, a decrease in bone density rises thus leading to the potential for osteoporosis.  In addition studies have shown that an increase in strength can:

·       Result in a decrease in arthritic pain

·       Improve balance and flexibility

·       Assist in balancing blood glucose levels

·       Have a positive impact on our emotional being

·       Strengthen the heart

·       And much more

So let us start by figuring out our own ratio of body fat to lean muscle.  There is a means of measuring this called the Body Mass Index or BMI.  BMI is a comparison of your height to weight.  This formula is being used more and more in the medical field and yet it is not necessarily an accurate way to measure body fat, in my opinion.  Take the individual who is very muscular and consequently quite lean.  They will come up on the BMI chart as having too high of a body mass index for their size.  Again this is because of the fact that muscle is so much more dense than fat.  A very small person, with a body fat of say 15%, will appear fat on with this measurement.  Or the body builder that is 5’6” and weighs 240 pounds.  His body fat may be around 12% and yet on a BMI chart he will show up obese.

A better way to determine the ratio is through actual measurement of body fat.  This can be done at a gym by using calibrators where skin is lifted from the muscle and measured on various parts of the body.  It can also be done in a pool by measuring how fast you sink; supposedly a better way and yet not too easily found.  For those of you that don’t have access to these kinds of measurements, I did find a source online that seems pretty accurate.  Simply go here to take that test:  http://www.healthcentral.com/cholesterol/home-body-fat-test-2774-143.html

Once you have this information you have the power to change it.  Rather than think, ‘I’m doomed!’ it is time to think positive.   It means you have an opportunity to make changes that can have an incredible impact on your health, your future and how to enjoy the balance of your life.  An Encore Life.  How great is that?

As time goes on and the kids are grown, there is more time to focus on ourselves separately and together with our partners.  It is a time to engage in new endeavors.  To think outside the box.  To explore things that we might have thought about in the past but just didn’t have the time to try.  It is time for an even better life!

Building muscle requires resistance.  When a muscle is challenged physically it puts stress on the bone.  The bone in response creates additional osteoblasts or cells that produce more bone.  The process is known as the piezoelectric effect.  Greater stress = more cell production=denser bones.  And, as mentioned, this is an excellent way to prevent osteoporosis.

Not only will that additional muscle strengthen your bones but it will increase your basal metabolic rate or BMR.  This is the basic amount of energy needed per day to function.  Additional muscle mass = higher BMR = additional calories burned.  Therefore a person with a higher ratio of muscle to fat can and actually needs to eat more.  Now isn’t that a great thing!  Of course what we eat is important as well.  To create these positive changes requires a blend of exercise and diet but for the purpose of this article let us focus on the exercise portion.  The diet will be addressed in a future article.

For now, let us take a look at the ways in which we can increase our muscle mass.  Of course there is the obvious – going to the gym to lift weights.  This is a great way and works fantastically for some.  For others this sounds like a death sentence!  Here are some additional ideas that can be really fun, give you a cardiovascular workout as well and offer resistance training:

·       Hiking up and down hills (my personal favorite).  Although this doesn’t address the upper body it is great for your legs and hips.  You would need to supplement with some upper body training.

·       Rowing.  This fun sport actually uses both your upper body and (to my surprise) a great deal of legs.  Overall it can really offer resistance as well as cardiovascular fitness.

·       Yoga can be a good form of resistance training, especially the more aggressive types such as Ashtanga Yoga.

·       Taking classes such as certain forms of dance, boot camps and so forth.

·       Kayaking.  This is more for building upper body strength but it is fast-paced and fun!

·       Rock Climbing.  Now this one might really take you to a new place!

·       Even the Wii Fit can offer those that want to stay inside a great workout.

These are just some ideas.  Play around with different types of activities that you enjoy and see if it fits into a strength or resistance training category.  Do not buy into the, ‘well I’m getting older…’ mentality.  Step out and up and make tomorrow even better than today!  You will be amazed at just how much you can change your body and fitness level!  We are only limited by our imagination so be creative, build muscle and head towards a more dynamic, healthy future!

WHEN I AM 64 WILL I BE HAPPY?

When I am 64 will I be happy? (Part 1)

BLOGGER:  PAUL GRIFFIN, PHD

In 1967, one of the first major reviews of happiness appeared in the psychological literature. It might seem hard to imagine now with new books on happiness popping up every month or so, but at that time happiness was of relatively little academic concern within psychology. Therefore, this article by a psychologist named Warner Wilson was quite valuable because it attempted to review and synthesize all of the studies on happiness up to that point and draw some conclusions based on this research. Among such conclusions was one that still seems persuasive to many: when it comes to happiness, better to be young.

Each year I teach an undergraduate class on the psychology of happiness. With the exception of a student or two, most of these students are in their late teens to early 20s. When I ask them to hypothetically compare the happiness levels of 20 and 30 year olds with those who are in their 60s and 70s, usually more than 60% pick the younger group (I suspect the numbers would be even be larger if it weren’t for the fact that by asking the question I am priming them to go against their instinct). Perhaps unless you are over 50 it is hard to think that being older means being happier. Why should it? After all, doesn’t getting older mean getting worse? Yes, it is true that the advent of modern medicine along with the rise of gerontology and education about aging has led to some shift in the way we think of older adulthood. However, while today’s 60 was yesterday’s 50, it doesn’t mean that common negative stereotypes of aging still do not persist. As one student asked, what is so great about losing cognitive skills, physical mobility, freedom, and social stature? Or as another student more bluntly put it, “not getting it up” can hardly make for a happy life.

Young adults’ mistaken perceptions of what awaits them in the coming years might lead to false conclusions about happiness in later life, but I think that there is more to it than that. In fact, while often grossly overstated by some, the aging process does involve decline in a number of areas, including certain cognitive skills and especially in a variety of physical abilities. And although there is a certain level of esteem and respect that is garnered as one ages (and, one hopes, progresses), our society still places great value on youth and the associated beauty, vigor, and excitement that comes with it. Regardless of the myths, in many respects, getting older can be hard. The often intuitive belief that being young means being happier makes perfect sense to me.

Let me reiterate, though, that Wilson’s early conclusion about happiness and aging were not based on intuition. This argument was based the existing research at the time. So this would be a pretty depressing post if I told you that this was the end of the story, that four decades later we have come to the scientific conclusion that it sucks to be old. In fact, something interesting happened—well, interesting enough, that I went on to do my doctoral dissertation on the subject (which according to some friends, hardly makes it interesting). After Wilson’s review, gradually more studies began to be conducted on the subject. The reason for this was twofold: greater attention to issues surrounding the aging process and more study devoted by psychologists, as well as related fields, to the question of happiness itself (I will have more to say about that in a later post). And not just more research, but better research. With each ensuing decade, the instruments being used were more precise and the populations being studied were larger and more diverse.

So now the interesting part. Through the 1970s and early 1980, a number of different studies did not find evidence that the young were happy than the old. In fact, by 1984 in the second major review of the literature, Ed Diener—one of the most prominent researchers in the area of happiness—had to amend Wilson’s original conclusion about age and happiness. At this point the research indicated there was no significant relationship between the two variables. In other words, age played little role in predicting happiness. Although there were certainly differences across individuals, there didn’t seem to be enough evidence to suggest that happiness varied in any predictable ways across age groups. If that still isn’t interesting enough for you, it gets better. After this review by Diener, there continued to be a significant amount of research on the question of happiness and aging. Again, this was due to the continued interest in gerontological issues and in an explosion of research on predictors of happiness. What began to emerge was a picture that surprised by many. So much so, that it was even identified as a “paradox.” Why a paradox? Because not only did it contradict Wilson’s earlier assertions, it went against the intuitive belief I spoke about before, the idea that aging and its associated rigors should lead to greater levels of unhappiness. These newer research suggested the exact opposite: there, indeed, was a relationship between age and happiness, and that relationship was positive. Getting older meant getting happier.

Let me give you one example of a study that changed the tide. In 1998, a young researcher named Dan Mroczek (along with his student Chris Kolarz) published research from a national database known as the MIDUS study. There had already been research suggesting that older people might be happier than the young, but perhaps due to the large sample size (over 2,500 people) and the sophisticated level of analysis, this study received considerable national attention. These researchers found that when comparing a group that ranged from their mid 20s to mid 70s, general levels of positive emotions increased across age groups while negative affect declined. Soon after they published their results, these findings appeared in a host of news outlets (it even provided material for Jay Leno’s opening monologue on the Tonight Show). In many respects, this study seemed to be the perfect conclusion to a decade of research on “positive aging.” For some time a number of researchers had been focused on the issue of understanding emotional changes across the lifespan, and Mrozcek’s study seemed to confirm many of their own positive conclusions about emotional well-being in late life.

So there you have it: when you are 64 you will be happy. Well, not exactly. Of course, no one study can ever then be used to predict an individual’s life. I hope to say more about individual differences—and factors related to such differences—at a later date. But let’s return to the general question of age differences and happiness. Does research substantiate the claim that aging more often leads to a rise in levels of happiness? A decade since Mroczek’s findings, there have been a number of studies that seem to confirm their results. At least when it comes to emotional well-being, these findings paint an optimistic picture of later life. Although it might be hard for someone younger than middle-age to imagine it might be so, a considerable amount of research suggests that happiness is not the provenance of the young.

Of course, some of you might not be surprised by this. In some cases, it might be because you are young and you are thinking, well it has to get better than this. Or maybe you are currently in middle-age or older and can tell me first-hand about this effect (as many of my older graduates have done). Or perhaps, even, you have read about these findings somewhere. Every several years you will find news outlets reporting the “surprising” finding that older individuals are happy! (The fact that this relatively old news is still newsworthy tells us how hard it is for us to believe it is true.) More than ever before—most especially in academic circles—there is an optimistic picture of life in later adulthood. In fact, it is not uncommon to hear the assertion that you get happier as you get older.

Now here is the part where I say that everything I have told you thus far is wrong, and you get annoyed. Well, not exactly. In fact, I do believe that there is considerable evidence to suggest that for many, happiness does increase across the lifespan. I certainly convinced that the notion that you are happiest in young adulthood is false. However, it seems to me that research over the last few years indicates that we might have painted an overly optimistic picture of such changes. In recent years researchers have sought to dissuade many from the stereotypical belief of the cantankerous old man as emblematic of the elderly population, and then replace him with the glossed over picture of a man swimming laps in the pool. There is good reason for this, and I find nothing wrong with our attempt to shift negative perceptions of aging. But what is missing is a more nuanced picture of an expanding cohort of elderly individuals. Although the media loves a happy ending, in my next post I would to discuss why we might needs to shift some of these assumptions about happiness once again. It might be true that you are likely to be happy when you are 64 and 74, but things seem more complicated when we start looking beyond to an elderly population that represents the fastest growing age cohort in the U.S.

For more information about Dr. Griffin, click his photo below:

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WHY I LIKE WORKING WITH OLDER PEOPLE

Why I like Working with Older People

BLOGGER: LAURA TRAYOR

My boss is a 74-year old woman who is by far, the best manager I’ve had in my 20+ year career.  She’s curious, energetic, charismatic and above all, connected.  She’s the antithesis to prevailing aging stereotypes that depict older workers as those who tire too easily, get sick often, or are just too rigid or slow for a fast paced workplace.

Not only is my boss an older person, but so too are most of the people I routinely work with.  They’re all 50+ and many are in their 60s and 70s.  I consider myself fortunate to work with such an interesting and inspiring group of people, which is why I’m always perplexed when I read about the difficulties older people face when looking for a new job or re-entering the workforce.  I recently came across a press release from the US Equal Employment Opportunity Commission (EEOC) that featured findings from a public hearing on developments (widespread layoffs, threats to benefits) under the Age Discrimination in Employment Act.  Expert panelists testified about “conscious and unconscious aging stereotypes” that cause employers to undervalue the contributions older workers make to their organization.  Moreover, because of these stereotypes, older workers are targeted disproportionately during workforce reductions. (http://www.eeoc.gov/press/7-15-09.html.).

I think hiring and HR managers have it all wrong.  There’s a lot to be said for the experience that comes from lives lived.  Like the following:

• High powered connections – my boss can pick up the phone and reach government officials or executives at leading health care organizations;
• Appreciation that time is an important commodity that should not be wasted in meaningless meetings;
• Willingness to take risks because they can handle rejection and are past caring about what other people think (did you know over the past decade or so, the highest rate of entrepreneurial activity is among those 50+?  Check out this report: http://www.globalaging.org/health/us/2009/entrepreneurship.pdf);
• Ability to follow through on their word – older workers are incredibly dependable;
• Perspective – will the world really come to an end if you miss a deadline?

So my advice to any hiring managers reading this blog is to think twice the next time a “seasoned” resume or older job applicant comes your way.  Cast aside those ageist stereotypes and focus instead on the valuable skills and experience this person can bring to both your organization – and your life.

Laura Traynor is a project manager with The Transition Network, a growing non-profit organization for women 50+.  Together with her boss, Charlotte Frank, she manages the Caring Collaborative, an innovative program of strategic assistance offered by friends and neighbors to help women effectively handle emerging health issues ( www.ttncaringcollaborative.org ).

To find out more about Laura and the ImagineAge bloggers, click her photo.

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NOW THAT I AM ALMOST 64

Now that I am almost 64, who will meet my needs when I am 84?

BLOGGER: DEBBIE HEISER

AUTHORS:

Deborah Heiser, Judith L. Howe, Robert Maiden, Beverly Horowitz, Pat Brownell

When you think of growing older, what comes to mind?  Fun, family, golf, workforce issues…?  Workforce issues?  Yes, workforce issues.  Believe it or not, we need to pay very close attention to them.  Each day 8,000 baby boomers turn 60.   In 2011, 78 million baby boomers will begin to turn 65. The Bureau of Labor Statistics (2005) estimates the demand for employment in aging will increase 26% over the next few years – particularly in health related jobs.  All the while, those 85 years and older are the fastest growing segment in the U.S. population.  This age group is expected to double in 2030 to 9.6 million and to double again by 2050.

Unfortunately, there is a down side to all of this longevity.  There is a HUGE need for a trained workforce to serve the aging.  According to Boxer and Collins (20007), 8 out of 10 older adults have at least one chronic illness and, of those, about 2/3 have multiple chronic conditions that require complex treatment and coordinated care.  Maiden, Chireac, and Maiden (2002) found that 50% of people requiring in-home care are 85 but older-family members find it difficult to secure, manage, maintain, and pay for adequate in-home assistance.  To met the demand, we need 36,000 certified geriatricians; we only have 7,128 in the U.S.  Despite the demand, and the increase in demand, the supply of in-home workers remains very low and is expected to remain low.  Even those who are available receive very little training and are then asked to perform functions they are not adequately trained for (Maiden & Maiden, 2004). Only 5% of social workers are trained in aging issues and only 3% of advance practice nurses specialize in aging.  “Besides being inadequately prepared in geriatrics, the current workforce is not large enough to meet older patents’ needs. and the scarcity of workers specializing in the care of older adults is even more pronounced” (Institute of Medicine, 2007, p. 5).

To determine what was going on in education, Dr. John Krout, a professor in New York State and a Past President of the State Society on Aging of New York, recommended taking a look at the New York State Institutions of Higher Learning.  Based on this recommendation, an inventory of all schools within the state was conducted.  The findings were astonishing!

Of 242 schools in higher learning:

Note  ***Only one school, now defunct, offered a PhD.

The State Society on Aging of New York (SSA) and The State Office on Aging of New York (NYSOFA) teamed up in 2007to create the Workforce Project charged with understanding training needs in the State of New York. The SSA and NYSOFA conducted a series of 8 Listening Sessions across the State.  The notes taken during each of the Listening Sessions were compiled and a content analysis was conducted to systematically identify key words and phrases used at each Session to determine important structures and themes.  The results are based on ratings provided by three independent coders who identified and tallied themes discussed at each of the Listening Sessions.

A total frequency and percent of discussion associated with each key topic was determined for each of the seven major discussion questions that framed the Listening Sessions.

The 7 Questions asked at each of the 8 Listening Sessions were:

Question 1:
Do you see a need for more education about aging staff in your organization?

Question 2:
On what topic would you like to see more education?

Question 3:
How should training / educational opportunities be presented?

Question 4:
What credentialing and certification should be considered?

Question 5:
Should gerontology be infused into college curricula?  Across disciplines?

Question 6:
What is the ability of organizations to support education/training for employees

Question 7:
Other comments

The Top 10 Key Findings were:

žThe findings from the Listening Sessions, as described in the Content Analysis show that a variety of issues were brought up.  Some were brought up only once, and some several times.

The organizations collaborated again at the SSA’s Annual Conference in 2008 to discuss the findings and “next steps” with 120 conference participants.  The participants completed questionnaires.  Notes were taken and were reviewed for key themes with regard to the four workforce training and education questions posed to the group. The results are broken down by question:

Question 1:
What do you think are good next steps we can take?

The overarching theme for this question was education. Forty seven percent (47%) of the responses and notes highlighted the need for education from k-12 and.  Additionally, they recommended educating college students earlier in their undergraduate education, and employing online education.  Other responses with suggested sensitivity training for gay/lesbian issues in training aides, elder abuse training, expanding nursing programs, fully funding GECs, emphasizing Geriatrics as a career, exposing teachers to SSA and Teach for America, and grassroots efforts.

Question 2:
Of the top 10 key issues identified, what do you see as the most important to focus on?

There were three distinct themes for this question.  Thirty nine percent (39%) of the responses advocated education, 39% training, and 22% financial aide and incentives.  With regard to education, the responses were: education for k-12 and all curriculum, college students receiving education earlier in their undergrad education, and online education.  Training responses were: aide training, caregiver training, and work-site training and mentoring.   Financial aide and incentives were not broken down further.

Question 3:
How can we – area agencies, academics, practitioners, and government – work together to move workforce education and training issues forward?

There were two distinct themes for this question with 42% of the responses advocating financial solutions (financial aide and incentives, support the Boxer Bill, and fully fund GECs) and 31% supporting increased education (education – k-12 and all curriculum, online education, and pilot curriculum programs for secondary education

Question 4:
Can you think of any other incentives for promoting education and training in aging?

Nearly 67% responded that there was a need for community service for high school students; approximately 33% responded that there is a need for increased payments and reimbursement for medical and social services.

Recommendations coming out of the Next Steps, SSA conference, mirrored the listening sessions.  They focused on education (k-12 in particular, and online training).  Responses for education were addressed in questions 1-3, and for two of the three questions, was a top response.

NowWhat?

We must now move toward addressing the issues brought up by New Yorkers as key workforce issues.

Let us know what you think!  Leave a comment below!

To read the full report published in 2008 by NYSOFA, please go to the State Office of Aging of New York Website: http://www.aging.ny.gov/ReportsAndData/WorkforceEducation/Introduction.cfm

To read this article on the SSA website, please go to: www.ssany.org

To become a member of the State Society on Aging of New York, please go to: www.ssany.org

To find out more about Dr. Heiser, click the photo below:

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Boomerville USA

 

A Fun Site for Boomers

In order to keep our visitors up-to-date with some of the other sites geared toward boomers, we are including links on our home page and you can read a bit about one of our most recent additions here…Boomerville USA.  

BOOMERVILLE USA – A FREE SOCIAL NETWORK FOR BABY BOOMERS everywhere. Boomers reign and rock…after all there is strength in numbers!  A Baby boomer is a term used to describe a person who was born during the Post-World War II baby boom between 1946 and 1964. No matter where you fit into the mix, check out BOOMERVILLE USA.

You will find like Boomie minds are hanging out here.  If you want to reminisce at our MEMORY LANE group just add your thoughts to the threads or start a new one. You can post a Youtube or watch some of what is there; share your thoughts at ANOTHER POLITICAL VIEW; or share recipes at FOOD FOR THOUGHT.  If you lean to anything paranormal, my successful MEDIUMS AND LOST PALLIES group, which I ran for years on EONS is now at Boomerville USA. Check us out, you might decide to have a seat at our very popular THE CYBERBAR IS ALWAYS OPEN!! group and play a few games or read the Showbiz news. Its all up to you!  

Click the hyperlink OR the logo to visit Boomerville, USA 

http://boomervilleusa.ning.com/

To go back to the home page, click below.

FINDING HOME CARE FOR ILL OR AGING PARENTS

Finding Home Care for Ill or Aging Parents

BLOGGERS: ROBERT F. BORNSTEIN, PHD

MARY A. LANGUIRAND, PHD

In an earlier blog we talked about strategies for coping with caregiver stress–finding ways to manage the upset that follows those inevitable glitches and setbacks that occur when caring for an ill or aging parent.  In this blog we explore one way of preventing caregiver stress before it occurs: a professional caregiver.

There are many different types of home care services, and they vary according to the care-receiver=s needs.  The more complex the problem, the more highly trained the caregiver must be, and the higher the cost.  The average cost per visit for a home care nurse today is more than $120; the average cost per visit for a home health aide is more than $60.

To be covered by Medicare, a service must be ordered by the patient’s physician, who declares the service medically necessary.  A wide range of in-home services can fall into this category, including:

·      Skilled nursing care

·      Speech, physical, and occupational therapy

·      Dietary and nutritional consultations

·      Some educational services (for example, diabetes self-care)

·    Rental or purchase of medical equipment (such as a wheelchair or blood-glucose monitor)

How can you fund services not covered by Medicare?  For many people the best option may be a long-term care insurance policy.  Unlike Medicare, most long-term care policies cover some custodial or non-skilled services (such as light housekeeping and transportation).  Eligibility criteria differ from policy to policy, and you should check with your insurer for details before you contract for services.

Who May Provide In-Home Care?

In-home care is typically provided by certified home health care agencies, and certified independent in-home caregivers (also known as independent providers).  A certified home health care agency is a corporation that provides a range of in-home services.  To become certified, the agency must meet stringent federal and state standards in a variety of areas.  Certified agencies must make their customer satisfaction data available to anyone who requests it, so don’t be shy about asking for this information: Reputable agencies are usually happy to share it with you (it’s a big red flag if they hesitate).

Not all good caregivers choose to work for agencies; many prefer to offer their services privately.  Independent providers can usually be located through Medicare, from insurance companies, via the web, or in the Yellow Pages (look under AHome Health Services@ and ANurses@).  Like home health care agencies, independent providers are required to meet certain criteria in order to be licensed.  They must have adequate training, and appropriate experience.  They must also have malpractice insurance, adhere to the ethical standards of their profession, and fulfill continuing education requirements to stay up to date on the latest findings and treatments.

How to Evaluate an Agency or Provider

Once you find an agency, or independent provider, how do you assess the quality of their services?  First, meet with them personally.  There=s nothing like a face-to-face interaction to help you judge a potential caregiver.  Second, review their credentials.  Everything should be in order here–no exceptions, no excuses.  Third, ask others about the provider=s performance.  Past clients are a great source of input.  Finally, trust your instincts.  If something feels wrong, it probably is.

Questions are important, but not all information can be obtained just by asking.  To evaluate a potential caregiver, you’ll need to judge a few things for yourself.  Any good caregiver–whether they’re an independent provider or employed by an agency–should have six qualities:

·      A professional appearance Although most caregivers don=t look like television nurses, a sloppy or unkempt appearance simply isn’t acceptable.  A professional caregiver should be clean and well-groomed, and dressed appropriately for the job.

·      Good observational skills A caregiver must be sensitive to changes in the patient’s condition–especially those the patient can=t describe directly.  Having the caregiver interact with the care receiver can be helpful in this regard.

·      Good communication skills A caregiver must be able to communicate clearly with folks who have perceptual problems (so don’t be surprised if they speak slowly, loudly, and very directly).

·      Quiet self-confidence Self-confidence is essential in a caregiver.  After all, part of the caregiver=s job is to provide reassurance to you and your loved one.  A good caregiver helps both patient and family member feel that everything is in good hands.

·      An open mind Caregivers and care receivers are often quite different–in age, gender, and perhaps religious or ethnic background.  Care receivers often vent their frustration on those around them, blurting out insults when depressed or upset.  An experienced caregiver expects this, and won’t take it personally.

·      A sense of humor Professional caregivers know to expect the unexpected.  Food gets spilled.  Bedclothes get soiled.  An even temperament and a dose of good humor are essential in a caregiver whose work is sometimes unpleasant.

Robert Bornstein and Mary Languirand are the authors of When Someone You Love Needs Nursing Home, Assisted Living, or In Home Care, published by Newmarket Press.  The second edition, revised and updated, was just released.  Here’s the link: http://www.newmarketpress.com/title.asp?id=901

To find out more about Robert Bornstein, click here to read his bio.

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Mammogram Morning

Mammogram Morning

BLOGGER:  ARIN GOLDMAN

Though October may be the official breast cancer awareness month, January is the month I have my annual mammogram.  As the daughter of a breast cancer survivor I am always nervous before my “mammo” but I have managed to control my apprehension level by following an annual routine.  On mammo morning I go for a run, shower,  resist the urge to put on deodorant, get to the radiologist’s office early and, once told  that my scans are clean, breathe a huge sigh of relief, schedule next year’s appointment and go out for something chocolate.  I had no reason to believe that last year’s routine would be any different but it was:  I flunked.

After taking the normal set of pictures, the technician came back to take another one of my left breast.  Since it is not that unusual to need a do-over or two, I was not  initially alarmed but that changed when she kept coming back for still more shots.  On the fourth take I started to hyperventilate and called for the as yet unseen radiologist who appeared to calmly explain  (just to be clear – she was calm, I was not) that the scans had located a cluster of micro-calcifications within my left breast, something that wasn’t there last year.  She explained that a micro-calcification cluster could be an early stage of breast cancer.  While she reassured me it was likely to be nothing, she said that it was important for me to have a biopsy and offered up an appointment for a stereotactic needle biopsy. Though I had little idea what that was I took the next available appointment for the following Friday, thankful that she did not think it was an emergency, but still very spooked.  When nothing else showed up on my accompanying sonogram,  I left the office clutching a piece of paper with the instructions for how to prepare for day of the biopsy, thoroughly confused by what a cluster of calcifications was and what I really should do next.

Ten years ago when my mother had needed a breast biopsy it was performed by a surgeon.   Was a radiologist the right specialist for this procedure?  I thought that I was medically savvy, but I had no idea what a stereotactic biopsy was, nor what it entailed.  I always scheduled my mammogram to take place mid-week because early on I had decided that if a problem was ever detected I would want to use one of my life lines and “call an expert” right away without any weekend interruption.  I was relieved that this year was no different and immediately called a high school friend,  a surgeon who headed up the breast cancer unit of a major medical center.   She confirmed  that times had changed with the less invasive stereotactic needle biopsy procedure replacing the scalpel for evaluation of calcifications like mine.  She also verified that this was a procedure best performed by a skilled radiologist.  Familiar with my radiologist and comfortable with her capabilities, she recommended that I go ahead with the procedure making sure to copy her on the results in case further action was required. 

Having contacted the expert, my next step was a Google search.  The ability to research medical conditions firsthand is a bit of a mixed blessing, there is a great deal of information available on the Internet but  alot of it is alarming.  Still  despite my jitters I needed to know more so I started surfing.  It did not take long to locate the information I was seeking. Individual calcifications generally do not raise much concern and frequently are just monitored closely.   However, micro-calcification clusters could be nothing at all or a stage zero or stage one form of breast cancer called ductal carcinoma in situ (DCIS).   While the term stage zero might sound pretty innocent, treatment involves both a lumpectomy and a program of radiation, not the news I wanted to hear but what I needed to know.  In terms of percentages, what the doctors had described as a highly unlikely chance of cancer was referred to on the web as a 15 to 20% probability. Thought not as much of a slamdunk as I hoped for, the odds were in my favor  that  this would  turn out to be nothing and if it was cancer my mammogram would have served its purpose by catching it at a very early, treatable stage.

On the day of the biopsy I arrived at the radiologist’s office still unsure of all the procedure entailed but anxious to get it over with.   First I was asked to lie down on a table with my breast positioned over a large hole.  A position as awkward as it sounds. A number of scans were taken to insure that I was positioned so that the targeted calcifications were accessible to the doctor. Given the location of my cluster and the modest size of my breast I had to be pan-caked into the table before the desired view was achieved and then, with the help of a few clips, I had to remain still for the next 45 minutes or so while the biopsy was completed.  The doctor had explained that this was the hardest part of the biopsy.  Awkwardly clamped to the table I found myself hoping that she had been telling the truth.  Fortunately it turned out that she was right, although very uncomfortable, there was nothing painful about the procedure itself.  After injecting my breast with a local anesthetic, a shot less painful than one at the dentist’s office, the radiologist employed a mechanically guided needle to individually remove each of the calcifications.  Once removed, a tiny tag was inserted into my breast to assist in the identification of the site in case any additional procedures were necessary.  No stitches were required; the radiologist merely covered the needle hole with a water proof bandage and  made me promise to wear a jog bra at all times for a few days for compression, to restrict my activities and to keep the wound site dry through the weekend so that there would be no bleeding or scar.  I went home, took it easy overnight, and then spent the weekend walking my dog with one arm,  replacing my usual run with time on the elliptical machine and trying hard to banish any alarming thoughts from my overactive brain.

On Monday, earlier than expected while I was in the shower examining the tiny red scar on my left breast, the doctor called with the best of all results. Everything was fine, my cluster was benign; no additional actions were required.  After the call, I dried off and got dressed, made an appointment for next year’s mammogram and went out for that much deserved chocolate anything.  One year later I am happy to report that this year’s mammogram morning went off with out a hitch.

To find out about Arin, click here to read her bio.

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Tips for Caregivers: Knowing When Your Loved One Needs Extra Help and Care

Tips for Caregivers: Knowing When your Loved One Needs Extra Help

BLOGGERS: ROBERT F. BORNSTEIN 

                        MARY A. LANGUIRAND 

Several years ago we wrote a book on nursing home care.  Since the book came out we’ve given talks on various eldercare-related issues, and part of what we do is try to dispel myths about assisted living facilities and nursing homes–myths that prevent people from planning effectively for the future.  One statement we’ve made at a number of talks seems to surprise people and stick in their minds: 

No one has ever entered a nursing home because they have Alzheimer’s disease, or because they broke a hip or had a stroke.  No one.  Never happened, never will.

There’s only one reason anyone ever enters a nursing home: They can no longer carry out activities of daily living.

Activities of daily living–or ADLs–are those well-practiced everyday tasks we do automatically, reflexively, almost without thinking.  Getting dressed, for example, or bathing on our own.  These tasks seem simple, and for most of us they are.  But illness or injury sometimes impairs our ability to carry out ADLs.  Sometimes the problems are temporary, but in other cases they’re lasting.  And that’s when extra help and care–sometimes nursing home care–is needed.

Eldercare professionals divide ADLs into two categories: basic and complex.  Basic ADLs include things like using the bathroom without help, or dressing appropriately for the weather.  Complex ADLs include things like shopping, cooking, and managing one’s medication.  When a person loses the ability to carry out complex ADLs, most often they require assisted living or in-home care.  When a person loses the ability to carry out basic ADLs, nursing home care is almost always required.

How can you tell when someone is showing enough functional decline to require in-home or out-of-home care? Five warning signs to look for:

• Food problems  These usually take two forms: improper food storage or improper preparation.  If you arrive at your mother’s apartment and find milk stored in the kitchen cabinet, that’s a red flag, and cause for concern.  Ditto if she serves you near-raw (or grossly blackened) hamburger (especially if she’s usually a good cook).

• A decline in cleanliness  Again, two forms–surroundings or self.  Sometimes you’ll notice a decline in cleanliness of the home (for example, dustballs in the bedroom or a filthy bathroom floor).  In other cases the problem may lie in the person’s hygiene–clothes unwashed (and more than a bit whiffy), or makeup sloppily applied.

• Unpaid bills or unopened correspondence  People who can no longer read or remember well enough to balance a checkbook may cope by simply ignoring their bills (or throwing them out), hoping the problem will go away.  Needless to say, it doesn’t.

• Confusion regarding day and date  Everyone is off a day or two every once in a while, thinking it’s the 12th when it’s really the 11th.  But when a person mistakes January for May, or asks if you’ve gotten your Thanksgiving turkey in July, it’s a troubling sign of disorientation, and an indication of cognitive decline.

• Forgetting familiar objects  Forgetting where you left your keys is no big deal–we all do that.  Holding a key in your hand and not remembering what to do with it….that’s a much more serious problem, and a telltale sign of cognitive deterioration.  Not necessarily Alzheimer’s disease (because a number of conditions can cause this symptom), but definitely something serious enough that you should take action.

Robert Bornstein and Mary Languirand are the authors of When Someone You Love Needs Nursing Home, Assisted Living, or In Home Care, published by Newmarket Press.  Here’s the link: http://www.newmarketpress.com/title.asp?id=901

 If you have questions or would like to know more about Caregiving, please leave a comment!  

To find out about Dr. Bornstein, click here to read his bio.

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Computer BASICS for Boomers

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Read the blog below.

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Hi I’m Larry Heiser

Computer BASICS for Boomers

I have been asked to help fellow boomers understand the basics of computers in terms and examples that are easy to understand.

I am not a wiz bang certified computer specialist so don’t expect a lot of fast phrased explanations in geek.

Like most of you, I use a computer every day at work and at home, and try to keep up with technology and how it relates to my specific needs.

It is my goal to translate what I have learned in simple terms, in the hope that it will help you better understand how to get the most out of your computer.

In upcoming episodes, I will present what I have come to understand about my computer.

I will talk about

The Central Processing Unit or CPU

Memory – do you have enough

Disk Drives (internal and external) – do you really know what it does.

Memory stick and memory cards

Data and system backup – do you have a backup of your stuff?

External devices that use: USB, FireWire, Bluetooth, and PCMCIA slots.

Internet and networking. Dial-up, DSL, Cable connections

If you have any questions about your computer, I will help you find the answer.

So send me a reply and let me know how I can help.

See you in the next blog.

Thanks

To find out more about Larry, click here to read his bio:

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